Payng by Check
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CHILD'S FIRST NAME: CHILD'S MIDDLE NAME: CHILD'S LAST NAME: CHILD'S HOMETOWN WHO SANTA SPOKE WITH: NICE ACTIVITY: NICE SANTA GIFT:
PLEASE COMPLETE THE ORDER FORM FOR E-CHECK
E-Mail Encrypted Check Systems
Your name as it appears on your check Your address as it appears on your check Your city, state & zip code & phone number , ,
Bank Name
Check number
Santa's Helper
$5.00
US Dollars
***FIVE DOLLARS*******
Type your full name here
9 Digit Bank Routing Code / Your Bank Account Number
For security reasons, please enter the last four digits of your social security number.
Enter your email address so that we may send you a receipt.